FAA Medical Certificate: Classes, Cost, and How to Apply

What Are the Three Classes of FAA Medical Certificates?

The FAA issues three classes of medical certificates. Each class corresponds to the type of flying you plan to do. Higher classes have stricter health requirements and shorter validity periods. All three involve the same basic exam — the difference is in the standards the examiner applies and how often you need to renew.

A key detail: when a higher-class medical expires, it automatically downgrades. A First-Class medical that expires after 6 or 12 months still functions as a Third-Class medical for private flying until that validity period runs out. So if you get a First-Class now, you do not need a separate Third-Class later — it covers everything below it until each tier expires.

For a full breakdown of pilot training costs in NYC, including the medical exam fee, see our cost guide.

Which Medical Certificate Class Do You Need?

Your medical class depends on what kind of flying you want to do. Most people starting flight training need only a Third-Class medical. Here is a simple decision framework:

• Hobby or recreational flying: Third-Class medical. This is the least stringent exam and lasts up to 5 years if you are under 40. It covers everything a private pilot needs.
• Career path toward the airlines: First-Class medical. If your goal is to become a career pilot, get a First-Class early. It confirms you meet the strictest health standards before you invest years of training. If something disqualifying shows up, you want to know now.
• Commercial flying (not airlines): Second-Class medical. This covers commercial pilot privileges like aerial photography, banner towing, or cargo operations that do not require an airline transport pilot certificate.

How Do You Apply for an FAA Medical Certificate?

The application process has two parts: an online form and an in-person exam. Plan to complete both within 2–3 weeks. You can also apply for your student pilot certificate at the same time through the same system, which saves a step.

Where Can You Get an FAA Medical Exam in NYC?

Two AMEs are popular with NYC-area student pilots. Both handle all three classes of medical certificates and can process your student pilot certificate application at the same visit.

Manhattan: Dr. Glenn Dangelman

• Location: Wall Street area, Lower Manhattan
• Phone: 212-233-3040
• Pricing: $250 for Third-Class or Second-Class, $300 for First-Class, +$25 for EKG
• Note: Credit card processing fees may apply

New Jersey: Dr. Raymond Basri

• Locations: Morristown, NJ and Middletown, NY
• Scheduling: myflightmd.com
• Note: Convenient if you plan to train at Morristown Airport (KMMU) or other New Jersey fields

After your medical, the next step is choosing where to train. See our guide to the best flight training airports near NYC for a detailed comparison.

What Should You Know About ADHD and Mental Health Medications?

ADHD, depression, and anxiety medications are among the most common complications in the FAA medical process. This does not mean you cannot get a medical certificate — but it does mean the process takes longer and requires more documentation. The FAA has specific guidelines for psychotropic medications, and many pilots successfully obtain their medical after providing the right records.

Here is what to know:

• ADHD medications (stimulants like Adderall, Ritalin, Vyvanse) are not approved for use while flying. However, if you were previously diagnosed with ADHD and are no longer on medication, the FAA may issue your medical after a waiting period and cognitive evaluation.
• Antidepressants: The FAA allows four specific SSRIs (fluoxetine, sertraline, citalopram, escitalopram) under a special authorization program called SSRI Decision Path. Other antidepressants generally require you to be off medication and symptom-free for a period before applying.
• Do not hide anything. The FAA cross-references pharmacy records, VA records, and insurance claims. Omitting a condition or medication can result in permanent certificate denial — far worse than a temporary delay while you work through the process honestly.
• Consult your AME first. Before filling out MedXPress, call an AME and describe your situation. An experienced AME can tell you what documentation to gather, what waiting periods apply, and whether to defer your application until everything is in order.

What Is BasicMed and Who Qualifies?

BasicMed is an alternative to the traditional Third-Class medical certificate. It allows certain pilots to fly without holding a current FAA medical, using a regular doctor (not an AME) for a physical exam every 48 months instead. Congress created BasicMed in 2017 to reduce the burden on recreational pilots who fly small aircraft.

To use BasicMed, you must:

• Have held a valid FAA medical certificate at any point after July 15, 2006
• Never have had a medical certificate revoked, suspended, or withdrawn
• Complete a medical education course online every 24 months
• Get a physical exam from any state-licensed physician every 48 months

BasicMed is not for student pilots. You need to have held a prior medical certificate to qualify. If you are just starting flight training, you still need a standard Third-Class (or higher) medical. BasicMed becomes an option later in your flying career — particularly useful for hobbyist pilots who want to avoid the AME process for renewals.

BasicMed also comes with limitations: you cannot fly above 18,000 feet, faster than 250 knots, or with more than 5 passengers, and the aircraft must weigh under 6,000 pounds. For private recreational flying, these limits rarely matter.

Can You Start Flight Training Before Getting Your Medical?

Yes. You do not need a medical certificate to begin flight training. You can fly with an instructor (dual instruction) and use a flight simulator without any medical certificate at all. The medical is only required before your first solo flight — the point where you fly the airplane alone.

That said, we recommend getting your medical early in training for a practical reason: if a medical condition creates complications, you want to know before you have spent thousands of dollars on flight hours. Most students can get their medical within the first few weeks of training with no issues.

See our guide on how to get your student pilot certificate — you can apply for both the student certificate and medical through the same MedXPress system.

Frequently Asked Questions

How much does an FAA medical certificate cost?

Expect to pay $200–$300 depending on the class and the AME. In the NYC area, a Third-Class or Second-Class medical typically costs around $250. A First-Class medical costs around $300. An EKG, if required, adds about $25. These are out-of-pocket costs — health insurance generally does not cover FAA medical exams.

How long does an FAA medical certificate last?

It depends on the class and your age. A Third-Class medical lasts 60 months (5 years) if you are under 40, or 24 months (2 years) if you are 40 or older. A Second-Class lasts 12 months regardless of age. A First-Class lasts 12 months if you are under 40, or 6 months if you are 40 or older. When a higher class expires, it downgrades to the next class automatically.

What happens if you fail your FAA medical exam?

Failing is not common, and it is rarely permanent. If the AME finds an issue, they may defer your application to the FAA Aerospace Medical Certification Division (AMCD) in Oklahoma City for further review. The FAA may request additional tests, medical records, or specialist evaluations. Many initially deferred applicants eventually receive their medical — it just takes longer. An experienced AME can help you navigate the process and avoid unnecessary deferrals.

Can you fly with glasses or contacts?

Yes. The FAA requires that your vision be correctable to 20/20 for distance and 20/40 for near vision. If you wear glasses or contact lenses to meet these standards, your medical certificate will include a limitation stating "must possess correcting lenses." You simply need to wear your corrective lenses every time you fly. This is one of the most common limitations and is not a barrier to any class of medical.

Do you need a medical certificate to use a flight simulator?

No. Flight simulators do not require any medical certificate, pilot certificate, or FAA authorization to use. Anyone can train in a simulator at any time. This makes simulator training an excellent way to start learning while your medical application is being processed — or simply to build skills before committing to the full expense of in-aircraft training.

Can you get a pilot medical with ADHD?

It depends on your situation. If you were diagnosed with ADHD but are no longer on medication, you may qualify after a waiting period (typically 90 days off medication) and a cognitive/psychological evaluation. If you are currently taking stimulant medication (Adderall, Ritalin, Vyvanse), you cannot hold an FAA medical while on those drugs. The FAA does not approve any stimulant medications for pilot use. However, many pilots with an ADHD history successfully obtain their medical — consult an AME before applying to understand your specific path.